PROJECT SUMMARY/ABSTRACT Transplantation holds the promise of reversing the clinical course of millions of Americans afflicted with end- stage organ failure, including a number of gastro-intestinal (GI) diseases. However, a number of issues limit broader access to transplantation and various complications related to the need for lifetime immunosuppression affect the long-term success of transplantation. Thus, the long-term objective of the Transplant Surgery Scientist Training Program (TSSTP) is to foster and support inter-dependent transplant research in order improve outcomes for patients in need of transplantation. We will leverage scientific advances in the life sciences across academic disciplines, and focus these on advancing transplantation, directly and indirectly improving the health of patients in need of GI organs, consistent with the mission of NIDDK. We will train the next generation of postdoctoral scientists (PhDs) and clinician scientists (MDs) in surgery and GI medicine who will advance the field of transplantation, preferably as team scientists. The specific aims of the TSSTP are 1) to educate trainees about the nature of existing barriers both to higher access to, and lower complications from transplantation, and 2) to arm them with a deep knowledge of state-of- the art tools, methodologies, and scientific approaches that can potentially be used to overcome these barriers. Significant `cross-talk' exists in clinical transplantation, thus, we will apply a training program that utilizes the Modular Approach to Transplant Research by Inter-disciplinary eXperts (MATRIX), a model that espouses the concept of inter-dependent team science and research between disciplines. This training model will be deployed across 2 separate training tracks that include 1) basic and translational scientific research within the Northwestern University Collaborative for Transplant Research in Immunobiology and Biomedical Engineering (NUCTRIBE), and 2) health sciences and outcomes research within the Northwestern University Transplant Outcomes Research Collaborative (NUTORC), and implement these in our second funding cycle. A total of 3 trainees will benefit for 2 years each from a customized MATRIX that will incorporate multidisciplinary co- mentoring. Each project must have a direct link to transplantation surgery, and the anchoring discipline in each MATRIX is a transplant clinician. The tactical objectives of this T32 are to: 1) provide stipend support for trainees; 2) provide multi-level, inter-disciplinary mentorship bringing together transplant clinician-scientists and non-clinician-scientists with state-of-the research methodologists; 3) protect trainees from clinical activities that compete for their time; 4) sustain an administrative structure that enhances both the quality and diversity of the candidate pool and trainees; 5) provide training opportunities that span the spectrum from both basic/translational science (NUCTRIBE) to clinical/health services and outcomes research (NUTORC) at their intersection with clinical transplantation; and 6) continue an ongoing evaluation process for determining whether or not the program is meeting its goals and objectives.